Subtrochanteric fractures following Gouffon pinning of subcapital femoral fractures.
Of the first 158 patients in a series of 292 consecutive patients treated for a femoral neck fracture with multiple pinning according to Gouffon's method (Howmedica Inc.), four (2.5 per cent) subsequently suffered a subtrochanteric fracture at the site of the distal pins. The configuration of the fractures was identical. These fractures occurred spontaneously while walking, and one occurred after slight direct trauma. Re-osteosynthesis was required in all four cases using a screw-plate device. If necessary, one or two pins were left in place to secure rotational stability. After a review of these cases and the literature, various modifications to Gouffon's method were introduced, and none of the following 134 patients suffered secondary fractures.
Neumann
L
L
Department of Orthopaedics, Svendborg Hospital, Denmark.
D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D011859:Radiography; D014945:Wound Healing